Despite the application of treatments that combine methadone administration, weekly counseling, and contingency reinforcement strategies, many opiate dependent patients continue a pattern of illicit drug use. The purpose of the proposed 3 year study is to fully develop and provide preliminary evidence supporting the usefulness of a novel cognitive-behavioral treatment designed to reduce illicit drug use among patients receiving methadone treatment. The treatment targets the reduction of sensitivity to interoceptive cues associated with drug craving using interoceptive exposure and cognitive-restructuring interventions; the treatment is termed, cognitive-behavior therapy for interoceptive cues (CBT-IC). The first year of the study will be devoted to the refinement of the treatment interventions and the development of a treatment manual. In the second and third years of funding, the standard treatment plus the CBT-IC program will be pilot tested against a program of standard clinical treatment. The two programs will be equated for therapist contact, assessment time, and contingency reinforcement strategies. Reduction in illicit drug use will serve as the primary dependent measure. The results of this study will provide pilot data on the effect size for the novel CBT-IC program relative to standard clinical treatment, and the feasibility of the study procedures, including the recruitment, retention, and assessment of opiate dependent patients. Once validated, this novel treatment emphasizing interoceptive exposure and cognitive restructuring may have application to a variety of drug abuse and dependence conditions.